An Unusual Case of Epistaxis—Juvenile Nasopharyngeal Angiofibroma

Karydes, Harry C.; Bailitz, John

doi:10.1016/j.jemermed.2010.02.012

Cited by 4 publications

(3 citation statements)

References 13 publications

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“…Juvenile angiofibroma is a highly vascularized locally invasive tumor arising from myofibroblasts that occurs most commonly in pre‐adolescent males. Its degree of vascularity and invasive properties may result in recurrent epistaxes . Any benign tumor impinging on the nasal cavity may, in fact, result in epistaxis as has been reported in pyogenic granulomas and oncocytomas .…”

Section: Specific Entities Associated With Epistaxismentioning

confidence: 99%

Lethal Epistaxis

Byard

2016

Journal of Forensic Sciences

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Epistaxis or nosebleed refers to bleeding from the nostrils, nasal cavity, or nasopharynx. Occasional cases may present with torrential lethal hemorrhage. Three cases are reported to demonstrate particular features: Case 1: A 51-year-old woman with lethal epistaxis with no obvious bleeding source; Case 2: A 77-year-old man with treated nasopharyngeal carcinoma who died from epistaxis arising from a markedly neovascularized tumor bed; Case 3: A 2-year-old boy with hemophilia B who died from epistaxis with airway obstruction in addition to gastrointestinal bleeding. Epistaxis may be associated with trauma, tumors, vascular malformations, bleeding diatheses, infections, pregnancy, endometriosis, and a variety of different drugs. Careful dissection of the nasal cavity is required to locate the site of hemorrhage and to identify any predisposing conditions. This may be guided by postmortem computerized tomographic angiography (PCTA). Despite careful dissection, however, a source of bleeding may never be identified.

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Section: Specific Entities Associated With Epistaxismentioning

confidence: 99%

Lethal Epistaxis

Byard

2016

Journal of Forensic Sciences

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“…[32][33][34][35] Another relatively infrequent cause of head and neck tumor-related hemorrhage is juvenile nasopharyngeal angiofibroma, a benign but highly vascular and locally aggressive tumor, which typically presents with intractable epistaxis in young patients. 36,37 Endovascular techniques provide a safe and effective measure to manage hemorrhage in these settings. 35,[38][39][40][41] Predominance of head and neck tumor-related hemorrhage involves ECA branches; however, CCA or carotid bulb may be involved.…”

Section: Endovascular Treatment Of Tumor-related Hemorrhagementioning

confidence: 99%

Interventional Management of Head and Neck Tumors

Kamran

Wallace

Adewumi

2020

Semin intervent Radiol

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Advancements in medical imaging and device technology allow minimal invasive procedures for the diagnosis and treatment of various disorders. For the management of tumors in head and neck region, these image-guided interventions play essential role in the often used multidisciplinary approach. Tissue sampling under ultrasound or computed tomography guidance is generally the first step to reach a pathological diagnosis. For head and neck tumors with high vascularity, embolization using particulate matter, liquid embolic agents, or coils is used to achieve successful tumor resection with minimal blood loss. Hemorrhage related to head and neck tumors can be evaluated and managed with endovascular techniques with minimal morbidity and mortality. Intra-arterial chemotherapy, radiofrequency ablation, and cryotherapy are new techniques for the management of advanced head and neck cancer which may serve as an alternative to achieve locoregional control and survival when curative resection may not be feasible.

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“…Epistaksis yang dikeluhkan pasien sifatnya berulang dan berat, seringkali sulit ditangani dengan penanganan epistaksis biasa. [1][2][3][4][5][6][7][8][9] Sejak abad ke-19, para peneliti telah mengajukan berbagai teori usulan mengenai asal muasal ANB. Sternberg dan Hubbard yang dikutip oleh Nicolai dkk 3 mengajukan hipotesis ANB sebagai suatu bentuk spesifik dari hemangioma, sementara Schiff, pada tahun 1959 seperti yang dikutip oleh Nicolai dkk 3 mengajukan teori jaringan vaskuler ektopik yang proliferatif.…”

Section: Pendahuluanunclassified

Bedah sinonasal endoskopik angiofibroma nasofaring belia: laporan seri kasus berbasis bukti (evidence based)

Wardani¹,

Mayangsari²,

Lisnawati³

et al. 2012

Oto Rhino Laryn Indones

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Background: Juvenile nasopharyngeal angiofibroma (JNA) is a histologically benign, but locally invasive neoplasm occurring most often in adolescent males. These tumors are highly aggressive andare associated with significant morbidity and mortality due to its tendency to bleed. Purpose: To presentevidence based case-report on endoscopic removal of JNA as an alternative technique besides the openapproach. Cases: Three cases of JNA managed endoscopically of their removal and the difference ofclinical symptoms based on the histopathological variation and radiological description analysis, givingbenefits in endoscopic surgical planning. Management: The classical treatment for JNA is surgery,however there are cases in which may indicate radiotherapy or even hormone therapy and gamma knifesurgery. Recent advances in technology enable ENT surgeons to use the endonasal technique as analternative in treating JNA patients. Conclusion: Endoscopic removal of JNA was successfully performedfor T1 and T2 tumor based on Fisch classification. To support a good management for JNA casesendoscopically, carefull considerations should be made to determine accesses toward the predominant attachment of the tumor to sphenopalatine foramen and pterygoid plate. Rhinologists and OncologyHeadandNecksurgeonsshouldhavedeepunderstandingofendoscopicanatomyoflateralnasalwalland mastering the art of four-hand technique of endoscopic sinonasal surgery. Keywords : angiofibroma, endoscopic surgery, sphenopalatine artery, pterygoid plate of sphenoid bone. Abstrak : Latar belakang: Angiofibroma nasofaring belia (ANB) merupakan tumor jinak secara histologis,namun bersifat ganas secara lokal yang terjadi terutama pada anak laki-laki usia remaja. Tumor jenis inibersifat sangat agresif dan sering dihubungkan dengan tingginya angka morbiditas dan mortalitas karenakecenderungan tumor yang mudah berdarah. Tujuan: Mempresentasikan 3 kasus dengan diagnosis klinisANB yang dilakukan ekstirpasi secara bedah sinonasal endoskopik. Telaah literatur terstruktur dilakukanuntuk menganalisis keputusan dan aplikasi pemilihan teknik bedah ini. Kasus: Tiga kasus ANB yangtelah dilakukan ekstirpasi dengan bedah endoskopik dianalisis berdasarkan variasi gejala klinis, gambaranhistopatologi dan gambaran radiologiknya yang berguna untuk perencanaan pembedahan sinonasalendoskopik. Penatalaksanaan: Tatalaksana utama ANB adalah dengan pembedahan, namun pada kasuskasustertentudapat dipilih modalitas radioterapi, terapihormon dan pembedahan dengan pisau gamma.KemajuanteknologimemudahkanparaahlibedahTHTuntukmenggunakanpendekatanendoskopisebagaialternatif pendekatan bedah pada pasien ANB.Kesimpulan:Bedah sinonasal endoskopikANBdapatdilakukanuntuktumorberukuranT1danT2berdasarkanklasifikasiFisch.Faktorlainyangharusdiperhatikanuntukkeberhasilantindakanadalahpemahamananatomiendoskopikhidungdansinusparanasal untuk penetapanakses secara sentripetalmenujuperlekatanutamaANBpada foramensfenopalatinadanlempeng pterigoid, serta kerjasama antaraahli Rinologi dengan ahli Bedah KepalaLeherOnkologi dalam teknik bedah sinonasal endoskopik 4 tangan (four-handtechnique). Kata kunci : angiofibroma, bedah endoskopik, arteri sfenopalatina, lempeng pterigoid os sfenoid.

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An Unusual Case of Epistaxis—Juvenile Nasopharyngeal Angiofibroma

Cited by 4 publications

References 13 publications

Lethal Epistaxis

Lethal Epistaxis

Interventional Management of Head and Neck Tumors

Bedah sinonasal endoskopik angiofibroma nasofaring belia: laporan seri kasus berbasis bukti (evidence based)

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